Herbal Textual Research on Olibanum in Famous Classical Formulas / 中国实验方剂学杂志

By consulting the ancient and moderm literature， this paper makes a textual research on the name， origin， quality evaluation， harvesting and processing of Olibanum， so as to provide a basis for the development of the famous classical formulas containing this medicinal material. According to the herbal textual research， the results showed that Olibanum was first described as a medicinal material by the name of Xunluxiang in Mingyi Bielu（《名医别录》）， until Ruxiang had been used as the correct name since Bencao Shiyi（《本草拾遗》） in Tang dynasty. The main origin was Boswellia carterii from Burseraceae family. The mainly producing areas in ancient description were ancient India and Arabia， while the modern producing areas are Somalia， Ethiopia and the southern Arabian Peninsula. The medicinal part of Olibanum in ancient and modern times is the resin exuded from the bark， which has been mainly harvested in spring and summer. It is concluded that the better Olibanum has light yellow， granular， translucent， no impurities such as sand and bark， sticky powder and aromatic smell. There were many processing methods in ancient times， including cleansing（water flying， removing impurities）， grinding（wine grinding， rush grinding）， frying（stir-frying， rush frying， wine frying）， degreasing， vinegar processing， decoction. In modern times， the main processing methods are simplified to cleansing， stir-frying and vinegar processing. Nowadays， the commonly used specifications include raw， fried and vinegar-processed products. Among the three specifications， raw products is the Olibanum after cleansing， fried products is a kind of Olibanum processed by frying method， vinegar-processed products is the processed products of pure frankincense mixed with vinegar. Based on the research results， it is recommended to select the resin exuded from the bark of B. carterii for the famous classical formulas such as Juanbitang containing Olibanum， processing method should be carried out in accordance with the processing requirements of the formulas， otherwise used the raw products if the formulas without clear processing requirements.

Systematic investigation on the anti-rheumatoid arthritis material basis and mechanism of Juan Bi Tang. Part 1: Integrating metabolic profiles and network pharmacology.

Previously, our cooperative team confirmed the chemical composition and anti-rheumatoid arthritis (RA) efficacy of Juanbi-Tang (JBT), a clinically and historically used traditional Chinese medicine formula, in two model animals. In this study, we developed an in vivo-in silico strategy to elucidate the anti-RA material basis and mechanism of JBT. With the aid of high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF), the metabolic profiles were investigated in normal and collagen-induced arthritis RA rats following oral administration of JBT. Based on the absorbed constituents in RA rats, network pharmacology was employed to predict the anti-RA mechanisms, followed by molecular docking validation. Consequently, there were 18 absorbed compounds with 6 chemical structures, which were absolutely identified by matching with standard compounds in plasma, and 17 generated metabolites involved of 7 biotransformation pathways, including glucuronidation, sulfation, hydroxylation, deglycosylation, methylation, taurine, and glycine conjugation. Moreover, RA disease affected the absorption and metabolism of the constituents in JBT, given the undetected 2 absorbed compounds and 4 metabolites in RA rats. The analysis of network pharmacology indicated that those absorbed compounds in JBT may fight against RA through the MAPK, FoxO, and Rap1 pathways. Molecular docking also validated these results. Overall, this is the first study to describe the metabolic profiles of JBT-treated healthy and RA rats, and it provides a possible anti-RA mechanism through multiple absorbed compounds and targets by network pharmacology.

Clinical Study of Modified Chushi Juanbitang Combined with Pedicle Vertebrotomy on Kyphosis of Ankylosing Spondylitis Due to Syndrome of Dampness-heat Obstruction / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Chushi Juanbitang combined with pedicle vertebrotomy on kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction. Method:The 90 cases were randomly divided into control group and observation group， 45 cases in each group. The patients in control group received pedicle vertebrotomy + <italic>Tripterygium</italic> glycosides， and the patients in observation group received pedicle vertebrotomy + modified Chushi Juanbitang. The treatment course was 6 months in both groups. Their bath ankylosing spondylitis disease activity index （BASDAI）， bath ankylosing spondylitis measure index （BASMI）， imaging index， traditional Chinese medicine syndromes， serum proinflammatory factor， anti-inflammatory factor， bone metabolism index ［bone-specific alkaline phosphatase （BALP）， tartrate resistant acid phosphatase isomer-5b （TRACP-5 b）， bone morphogenetic protein-2 （BMP-2）， osteocalcin （BGP）］， ossification related proteins ［bone morphogenetic protein-7 （BMP-7）， dickkopf-related protein-1 （DKK-1）， and tissue inhibitor matrix metalloproteinase-2 （TIMP-2）， sclerostin（SOST）］ were observed and detected. The clinical efficacy， recurrence rate and safety indexes were followed up for 12 months and compared. Result:The total effective rate was 97.73% （43/44） in the observation group， higher than 80.95% （34/42） in the control group （<italic>χ</italic>²=5.172， <italic>P</italic><0.05）. In the comparison with control group after treatment， the BASDAI， BASMI， imaging index， traditional Chinese medicine syndromes， proinflammatory factors， TRACP-5b， BMP-7 and TIMP-2 were lower in observation group （<italic>P</italic><0.05）， and the anti-inflammatory factors， BALP， BMP-2， BGP， DKK-1 and SOST were higher in observation group （<italic>P</italic><0.05）. During the follow-up for at least 12 months， the recurrence rate was 4.65% （2/43） in observation group， lower than 26.47% （9/34） in control group （<italic>χ</italic>²=4.261， <italic>P</italic><0.05）. There was no significant difference in the incidence of postoperative complications between the two groups. The incidence of adverse reactions was 2.27% （1/44） in observation group， lower than 38.64% （17/44） in control group （<italic>χ</italic>²=5.763， <italic>P</italic><0.05）. Conclusion:Modified Chushi Juanbitang combined with pedicle vertebrotomy is effective in the treatment of kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction.

Corrigendum: Alleviation of Synovial Inflammation of Juanbi-Tang on Collagen-Induced Arthritis and TNF-Tg Mice Model.

[This corrects the article .].

Alleviation of Synovial Inflammation of Juanbi-Tang on Collagen-Induced Arthritis and TNF-Tg Mice Model.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that is primarily characterized by synovial inflammation. In this study, we found that a traditional Chinese decoction, Juanbi-Tang (JBT), JBT attenuated the symptoms of collagen-induced arthritis (CIA) mice and in tumor necrosis factor transgenic (TNF-Tg) mice by attenuating the arthritis index and hind paw thickness. According to histopathological staining of ankle sections, JBT significantly decreased the area of inflammation and reduced bone destruction of ankle joints in both these two types of mice. Moreover, decreased tartaric acid phosphatase-positive osteoclasts were observed in the JBT group compared with those found in the control group. We also revealed that JBT suppressed monocytes and T cells as well as the production of CCL2, CCR6, and CXCR3 ligands. We next used high-performance liquid chromatography to investigate the components and pharmacological properties of this classical herbal medicine in traditional Chinese medicine. Based on network pharmacology, we performed computational prediction simulation of the potential targets of JBT, which indicated the NF-kappa B pathway as its target, which was confirmed in vitro. JBT suppressed the production of pro-inflammatory cytokines including interleukin-6 (IL-6) and IL-8, and inhibited the expression of matrix metalloproteinase 1 in fibroblast-like synoviocytes derived from RA patients (MH7A cells). Furthermore, JBT also suppressed the phosphorylation of p38, JNK, and p65 in TNF-α-treated MH7A cells. In summary, this study proved that JBT could inhibit synovial inflammation and bone destruction, possibly by blocking the phosphorylation of NF-kappa B pathway-mediated production of proinflammatory effectors.

Effect of Juanbitang Combined with Iontophoresis and Warm Acupuncture in Treatment of Wind Cold and Blocking Collaterals Syndrome Due to External Humeral Epicondylitis / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Juanbitang iontophoresis combined with warm acupuncture in treatment of wind cold and blocking collaterals syndrome due to external humeral epicondylitis (EH) and the effect on serum oxidative stress index. Method:From January 2018 to October 2019, 180 patients with EH wind cold and blocking collaterals syndrome were randomly divided into the warm acupuncture group, the traditional Chinese medicine（TCM） group and the combination group, with 60 cases in each group. The TCM group was treated with modified Juanbitang combined local iontophoresis at Quchi (affected side), Zhouliao (affected side), Ashi (affected side), 30 min/time/day, while the warm acupuncture group was treated with warm acupuncture once a day, 5 days/week. The combination group was treated with warm acupuncture in addition to the therapy of the TCM group, and the three groups were treated for 4 weeks. JOA’s elbow joint function scale, HSS’ elbow joint score scale and pain visual simulation score (VAS) were used to evaluate the symptoms and signs and the improvement of daily life before and after treatment. Enzyme linked immunosorbent assay（ELISA） method was used to detect the contents of late oxidized protein products (AOPP), malondialdehyde (MDA), superoxide dismutase (SOD) and heme oxygenase-1 (HO-1) in serum of patients before and after treatment. The cure rate, the total effective rate and the recurrence rate of 1 month and 3 months after treatment were compared. Result:Compared with before treatment, JOA and HSS scores increased, whereas VAS scores decreased (P<0.05). AOPP and MDA contents decreased, while SOD and HO-1 contents increased in the combination group and the TCM group (P<0.05). Compared with the TCM group and the warm acupuncture group after treatment, JOA, HSS score and pain R value increased, whereas VAS score decreased (P<0.05). Compared with the warm acupuncture group after treatment, serum AOPP, MDA content decreased, while SOD, HO-1 content increased (P<0.05). After 4 weeks of treatment, the cure rate and the effective rate of combination group were higher than those of the TCM group (χ2cure rate=4.617, χ2effective rate=6.471, P<0.05) and the warming acupuncture group (χ2cure rate=4.207, χ2effective rate=6.775, P<0.05). One month after the treatment, the cure rate and the effective rate of the combination group were higher than those of the TCM group (χ2cure rate=7.617, χ2effective rate=13.347, P<0.05) and the warm acupuncture group (χ2cure rate=4.762, χ2effective rate=6.277, P<0.05). The recurrence rate of the combination group was lower than that of the TCM group (χ2=9.32, P<0.05) and the warm acupuncture group (χ2=3.899, P<0.05). Three months after the treatment, the cure rate and the effective rate of the combination group were higher than those of the TCM group (χ2cure rate=4.789, χ2effective rate=9.643, P<0.05) and the warm acupuncture group (χ2cure rate=4.458, χ2effective rate=9.251, P<0.05). The recurrence rate of the combination group was lower than that of the TCM group (χ2=4.599, P<0.05) and the warm acupuncture group (χ2=4.518, P<0.05). Conclusion:Modified Juanbitang and the warm acupuncture has a good clinical efficacy in the treatment of EH wind cold and blocking collaterals syndrome and is worthy of clinical promotion.